From: anonymous@mac911.com
Subject: Deviated Septum in Montreal (need another opinion)
Posted-By: xx108 (ENT Clinic Moderator)
Organization: Organization For Community Networks
Date: Fri, 21 Mar 1997 16:08:14 -0500
Newsgroups: ofcn.clinic.ent

I am a 27 year old male, I have been experiencing a "fullness" in my left ear for the past one and a half years now, I had a throat infection in the summer of 95, which i've been told most likely caused my problem. I was prescribed NovaMoxin which resolved the infection but the "fullness" has remained a problem ever since. If I block the entrance of my nasal passage and blow, I can feel the area behind my left eardrum "pop". My right side is fine. I am a professional singer (rock style), so when I perform or practice, I don't have a proper balance of hearing myself properly which tends to make me sing off-key. Singing a little off-key and minor headaches are part of my life right now which never occured prior to my infection. I'm kind off worried since we've reached the attention of a few record companies. Isn't it ironic when things are going great?
Since Jan./97, I have been consulting series of Otolaryngologists, three to be exact, have been prescribed DRIXTAB three times/day, NASACORT 2 blasts/nostril/day, the symptoms remained. Have been prescribed CECLOR three times/day, CLARATIN extra strength 1 pill/day and NASACORT AQ 1 blast/nostil/day. My left ear still presents a problem to me.
I was given an audiogram and typanogram test, which resulted in perfect hearing in both ears. I have been diagnosed with a Deviated Septum, the air in my left nostril is indeed partially restrictive, especially at night just before sleeping. My last Doctor said that the Deviated Septum is causing pressure on my Eustachian tube behind my eardrum. I am in great health, performed blood and urine tests with no problems, I will be pursuing surgery in about four weeks, what do you think about this diagnosis?

Do you have any suggestions as to what not to eat or drink prior to a performance, and/or what to drink or eat?

Thank you very much.

Reply: ------------------------

A deviated septum certainly could cause problems with the eustachian tubes including causing imbalance in pressure equalization of the ears. In my experience the use of topical nasal steroids such as Nasacort frequently can be helpful when eustachian tube dysfunction persists well beyond an upper respiratory infection. However, if there is a significant deviation of the septum, this anatomic problem may prevent adequate flow of the medication into the nasopharynx where the eustachian tube openings are located. Thus it is certainly conceivable that a septoplasty could provide you with some benefit in this regard. However, I would proceed with a septoplasty mainly with the interest in improving the airflow through one's nose as the primary goal. I would urge caution if the ear symptom is the predominant problem that bothers you.

Regarding your latter question with respect to what to eat or drink prior to a performance, much of this has to do with your past personal experiences and dietary habits. In general I would avoid any food or beverages that in the past seems to increase the viscosity of your secretions. For many, dairy products will increase the thickness of secretions for example. I would also avoid beverages with caffeine since caffeine can act as a diuretic which can be potentially dehydrating. Fluids in general are advisable to enhance the moisture in the throat and vocal cords. Cigarette smoke (first or second-hand) should be avoided. You also mentioned taking Claritin which is an antihistamine. Antihistamines can dry your secretions up and therefore I would avoid them prior to performances.

--

Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis

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